Sexual life and medication taking behaviours in young men: An online survey of 92 620 respondents in China.

OBJECTIVES: To assess sexual life and medication taking behaviours in young Chinese men. METHODS: An online survey was conducted across China between January 2017 and April 2017. Among the participants, men aged 19-40 years were included in the analysis. The respondents filled in the online questionnaire assessing sexual life and medication taking behaviours by themselves, including general information, cognition of erectile dysfunction (ED) and treatment-related questions. Erection hardness score (EHS) was used to measure the erection hardness status. RESULTS: Among the young respondents, 20.54% had grade I-II EHS, 58.14% searched the internet for online ED-related information, 26.49% took an ED medication and 50.89% took an ED medication without the advice of a physician or pharmacist. The respondents who took medication had less sexual intercourse per week (P < .001) and worse EHS (P < .001), and were more willing to seek information from physicians, pharmacists, friends and relatives instead of online sources (P < .001), compared with those not taking medication. The most common comorbidities in patients with grade I-II EHS were hyperlipidaemia, cardiovascular disease (CVD), prostate diseases and diabetes mellitus. CONCLUSION: About 20% of young Chinese men needed further assessment for ED. The majority of respondents obtained ED-related information by online search and took an ED medication without professional advice. These data could help clinicians understand the current status of sexual life and medication taking behaviours of young Chinese men.

The prevalence of midline prostatic cysts and the relationship between cyst size and semen parameters among infertile and fertile men.

STUDY QUESTION: When is the investigation and treatment of midline prostatic cysts (MPC) of clinical value in the work-up of males of infertile couples? SUMMARY ANSWER: With a prevalence of 10.2% in infertile men, MPC should be investigated according to a seminal algorithm detecting a MPC volume >0.117 ml, which may impair semen parameters, and could be treated to improve sperm count and achieve natural pregnancy. WHAT IS KNOWN ALREADY: MPC are frequent and are considered a correctable cause of male infertility. However, they have been poorly investigated in an infertility setting. In addition, no study has investigated clinical and ultrasound (US) characteristics of men with MPC. STUDY DESIGN, SIZE, DURATION: A cross-sectional analysis was carried out of 693 consecutive subjects consulting for couple infertility from September 2012 to March 2017. As a control group, 103 age-matched healthy, fertile men were studied. Furthermore, a longitudinal evaluation of 11 infertile men undergoing trans-rectal ultrasonically-guided cyst aspiration (TRUCA), semen analyses 1 and 3 months after TRUCA and a follow-up 1 year after TRUCA to assess natural pregnancy were performed. PARTICIPANTS/MATERIALS, SETTING, METHODS: All subjects underwent, in our outpatient clinic, clinical, hormonal, scrotal and transrectal US evaluation and semen analysis within the same day. Of 693 males of infertile couples, 648 (37.1 ± 7.9 years, mean+SD) without genetic abnormalities were studied, along with 103 fertile men (36.6 ± 5.0 years). Eleven infertile men underwent TRUCA and were followed-up as reported above. MAIN RESULTS AND THE ROLE OF CHANCE: A MPC was present in 66/648 (10.2%) males of infertile couples and in 6/103 (5.8%) fertile men. MPC occurrence and volume were higher in patients with severe oligo- or azoospermia than in fertile men (all P < 0.05). Infertile men with a MPC showed a lower seminal volume and sperm count and a higher prevalence of azoospermia than the rest of the infertile sample or fertile men, and a higher frequency of US signs suggestive of ejaculatory duct obstruction. MPC volume was negatively associated with total sperm count (r = -0.452, P < 0.0001). In fertile men, the highest MPC volume was 0.117 ml, suggesting it as a biological threshold not compromising semen quality. In infertile men, using receiver operating characteristic curve analyses, a MPC volume >0.117 ml identified subjects with severe oligo- or azoospermia with an overall accuracy of ~75% (both P < 0.005). Eleven men with infertility, semen abnormalities and large MPC (>0.250 ml) underwent TRUCA, which led to sperm count improvement in all patients 1 month after surgery. Three months after TRUCA a lower sperm count and a higher MPC volume than 2 months before were observed (P < 0.005 and P < 0.05, respectively), although improved when compared to baseline. After TRUCA a natural pregnancy occurred in four couples. Finally, we propose an algorithm, based on semen parameters, useful in identifying a MPC in males of infertile couples. LIMITATIONS, REASONS FOR CAUTION: Although in line with the sample size of previous studies (n = 7-20), the number of infertile men with MPC evaluated longitudinally after treatment is limited (n = 11). In addition, although a MPC volume >0.117 ml can negatively affect the sperm count, only MPC > 0.250 ml have been treated in this study. WIDER IMPLICATIONS OF THE FINDINGS: First, the algorithm proposed is easy to use and useful for selecting patients who can benefit from a prostate US in the infertility work-up. Second, a MPC volume ≤0.117 ml may not impair semen quality, while a larger volume can lead to severe oligo- or azoospermia and could be treated. Third, TRUCA is effective, and simpler and less invasive than other surgical techniques for MPC treatment. Finally, since the MPC can increase in size and sperm count decrease over time after TRUCA, semen cryopreservation should be considered 1 month after TRUCA. STUDY FUNDING/COMPETING INTEREST(S): Grants from the Ministry of University and Scientific Research (SIR project to F.L., protocol number: RBSI14LFMQ). No conflicts of interest.

[Analysis of the prevalence and related risk factors of prostate diseases in traffic policemen].

Objective: To investigate the prevalence and related risk factors of prostate diseases in traffic policemen. Methods: A total of 848 traffic policemen who took part in the physical examination among August and September in 2016 were selected as research subjects, and a questionnaire survey was conducted to collect their information including smoking, alcohol drinking, biological and physiological indicators, as well as prostate disease etc. The relationship between the prevalence of prostate diseases and related risk factors was analyzed by Non-conditional Logistic Regression. Results: The total prostate disease prevalence rate was 40.2% in the study subjects, and there is statistical significance (P<0.05) of differences between prostate disease group and non disease group in age, work age, smoking, drinking and field work. Single factor analysis showed that age, work age, smoking, and field work are independent risk factors of prostate disease (P<0.05) . Multivariate Logistic regression analysis showed that increasing age (OR 1.03) , smoking (OR 1.92) and field work time (OR 1.47) significantly increased the risk of prostate disease in male police after age, smoking, drinking, BMI, systolic blood pressure, diastolic blood pressure, fasting blood glucose, blood lipids and other indicators were adjusted. Conclusion: age, smoking and field work time are risk factors of prostate diseases in the traffic police. There is great significance in publicizing the harmful effects of smoking and reducing the duration of field work.

Evaluation of dogs with macroscopic haematuria: a retrospective study of 162 cases (2003-2010).

AIMS: To retrospectively describe clinical features of dogs that were presented to a small animal clinic between 2003-10 with macroscopic haematuria, and investigate whether signalment of the dog and severity and duration of the haematuria at admission were associated with specific aetiologies. METHODS: Medical records were evaluated of 162 dogs with macroscopic haematuria admitted to a University-based small animal clinic in Thessaloniki, Greece, from January 2003 to December 2010. The inclusion criteria were discolouration of the urine sediment combined with abnormal numbers of erythrocytes, when examined microscopically. Data collected from the medical records included signalment, severity, frequency and duration of haematuria, and diagnosis. RESULTS: Between January 2007 and December 2010, 8,893 dogs were admitted to the clinic; of these 99 (1.1%) were admitted with haematuria. Of the 162 dogs with records of haematuria, 80 (49.4%) were aged between 5.1-10 years, presented with acute (96/162; 59.3%), constant (99/162; 61.1%) and mild/moderate (150/162; 92.6%) haematuria. Of 147 dogs with a recorded diagnosis, the commonest diagnoses were urinary tract infection (UTI, 42/147; 28.6%), urolithiasis (38/147; 25.9%), prostatic disease (25/147; 17.0%) and urinary tumours (13/147; 8.8%). The prevalence of UTI was higher in female (22/56; 39%) than male (20/91; 22%) dogs, and in medium sized (22/52; 42%) than small (6/40; 15%) dogs. Urolithiasis was most prevalent in small (21/40; 52.5%) dogs, and all dogs with urolithiasis presented with mild/moderate haematuria. The prevalence of prostatic disease was highest in large (11/46; 24%) and giant (3/9; 33%) sized dogs and in dogs aged >10 years (8/30; 27%). CONCLUSIONS AND CLINICAL RELEVANCE: In this retrospective study from one small animal clinic, UTI, urolithiasis, prostatic disease and urinary tumours predominated among the causes of canine haematuria. The consideration of sex, age, and size of the dog and characteristics of haematuria were found to be useful parameters when forming the list of differential diagnoses.

[Evaliating men's health survey results within the framework of "men's health school"].

Within the framework of "Men's Health School" 571 men were examined in 2014. The mean age of the surveyed men was 49.66+/-14.5 years. 86% (227) of the surveyed men had PSA levels from 0 to 4 ng/ml. Prostate ultrasound scan showed prostate enlargement in 37.2%+/-6.0 of men. The disturbances of libido or sexual life were registered in 45.5% (221) of the surveyed men. 58% of patients reported insufficient penile rigidity for sexual intercourse, 50% reported a sharp decrease in the amount of ejaculate, and 10% - pain during erection. Detailed medical history showed that in many patients the disease was provoked by family discord. The study findings revealed the poor condition of the male reproductive system in Kazakhstan. Resolving this problem requires considerable logistical costs, and an integrated approach to the early detection of diseases of the male reproductive system. The reproductive health of men was found to be affected by somatic, psychological and sexual health factors. At present we can say about the need for such "Men's Health School" in all regions on a regular basis, especially with the training of the primary care physicians.

Concomitant emphysematous prostatic and periurethral abscesses due to Klebsiella pneumoniae: a case report and review of the literature.

Although gas-forming infections of the urinary tract account for a very small percentage of all urinary tract infections, they can lead to mortality if an early diagnosis is not made and aggressive management initiated. Emphysematous urinary tract infections occur mainly in patients with poorly controlled diabetes mellitus or an obstructed urinary tract. Here we present a case of concomitant emphysematous prostatic and periurethral abscesses caused by Klebsiella pneumoniae in a 70-year-old male with poorly controlled diabetes mellitus. Given the high prevalence of patients with diabetes mellitus and the high mortality rate associated with emphysematous prostatic abscesses, clinicians should be aware of this rare but potentially fatal condition.

Association between cathepsins and benign prostate diseases: a bidirectional two-sample Mendelian randomization study.

Objectives: The relationship between cathepsins and prostate cancer (PCa) has been reported. However, there is a lack of research on cathepsins and benign prostate diseases (BPDs). This study investigated the potential genetic link between cathepsins and BPDs through the utilization of Mendelian randomization (MR) analysis to determine if a causal relationship exists. Methods: Publicly accessible summary statistics on BPDs were obtained from FinnGen Biobank. The data comprised 149,363 individuals, with 30,066 cases and 119,297 controls for BPH, and 123,057 individuals, with 3,760 cases and 119,297 controls for prostatitis. The IEU OpenGWAS provided the Genome-wide association data on ten cathepsins. To evaluate the causal relationship between BPDs and cathepsins, five distinct MR analyses were employed, with the primary method being the inverse variance weighted (IVW) approach. Additionally, sensitivity analyses were conducted to examine the horizontal pleiotropy and heterogeneity of the findings. Results: The examination of IVW MR findings showed that cathepsin O had a beneficial effect on BPH (IVW OR=0.94, 95% CI 0.89-0.98, P=0.0055), while cathepsin X posed a threat to prostatitis (IVW OR=1.08, 95% CI 1.00-1.16, P=0.047). Through reverse MR analysis, it was revealed that prostatitis had an adverse impact on cathepsin V (IVW OR=0.89, 95% CI 0.80-0.99, P=0.035), while no favorable association was observed between BPH and cathepsins. The results obtained from MR-Egger, weighted median, simple mode, and weighted mode methods were consistent with the findings of the IVW approach. Based on sensitivity analyses, heterogeneity, and horizontal pleiotropy are unlikely to distort the results. Conclusion: This study offers the initial evidence of a genetic causal link between cathepsins and BPDs. Our findings revealed that cathepsin O was beneficial in preventing BPH, whereas cathepsin X posed a potential threat to prostatitis. Additionally, prostatitis negatively affected cathepsin V level. These three cathepsins could be targets of diagnosis and treatment for BPDs, which need further research.

Male reproductive health disorders among Aboriginal and Torres Strait Islander men: a hidden problem?

OBJECTIVE: To better understand help-seeking behaviours and reproductive health disorders among Aboriginal and Torres Strait Islander men. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional mixed-methods study conducted from 1 May 2004 to 30 April 2005 of 293 Aboriginal and Torres Strait Islander men aged 18 years and over from urban, rural and remote communities in the Northern Territory and Queensland. MAIN OUTCOME MEASURES: Subscale of the International Index of Erectile Function, self-reported help-seeking behaviours for erectile dysfunction (ED) and prostate disease, thematic analysis of semi-structured interviews and focus groups. RESULTS: The prevalence of moderate-to-severe ED increased across age groups, from about 10% in younger men (under 35 years) to 28% in men aged 55-74 years. Moderate-to-severe ED was strongly associated with reporting a chronic condition (odds ratio [OR], 3.67) and residing in a remote area (OR, 2.94). Aboriginal and Torres Strait Islander men aged 40-59 years showed similar low levels of help-seeking behaviours compared with non-Indigenous men from a comparable population-based study. About half of the men with ED saw a doctor or received treatment for ED in each population. While prostate cancer rates were low in both studies, testing for prostate problems was less frequent in Aboriginal and Torres Strait Islander men (11.4%) than in non-Indigenous men (34.1%, P < 0.001), despite similar levels of concern about prostate cancer. Barriers to help-seeking included shame, culturally inappropriate services and lack of awareness. CONCLUSION: This study, the first to investigate reproductive health of Aboriginal and Torres Strait Islander men, found low levels of help-seeking behaviours for reproductive health disorders, with implications for missing a predictor of chronic disease and late diagnosis of prostate disease.

Impact of co-morbidities on self-rated health in self-reported COPD: an analysis of NHANES 2001-2008.

Chronic Obstructive Pulmonary Disease (COPD) coexists with co-morbidities. While co-morbidity has been associated with poorer health status, it is unclear which conditions have the greatest impact on self-rated health. We sought to determine which, and how much, specific co-morbid conditions impact on self-rated health in current and former smokers with self-reported COPD. Using the 2001-2008 National Health and Nutrition Examination Survey we characterized the association between thirteen co-morbidities and health status among individuals self-reporting COPD. Adjusted odds ratios (ORs) were generated using ordinal logistic regression. Additionally we evaluated the impact of increasing number of co-morbidities with self-rated health. Eight illnesses had significant associations with worse self-rated health, however after mutually adjusting for these conditions, congestive heart failure (OR 3.07, 95% CI 1.69-5.58), arthritis (OR 1.69, 95% CI 1.13-2.52), diabetes (OR 1.63, 95% CI 1.01-2.64), and incontinence/prostate disease (OR 1.63, 95% CI 1.01-2.62) remained independent predictors of self-rated health. Each increase in co-morbidities was associated with a 43% higher chance of worse self-rated health (95% CI 1.27-1.62). Individuals with COPD have a substantial burden of co-morbidity, which is associated with worse self-rated health. CHF, arthritis, diabetes and incontinence/prostate disease have the most impact on self-rated health. Targeting these co-morbidities in COPD may result in improved self-rated health.

THE PROFILE AND UROLOGICAL SERVICE NEEDS OF OUTPATIENTS ATTENDING A TERTIARY CENTRE IN WESTERN KENYA.

BACKGROUND: Urological service needs cut across varied ages and related conditions. The outpatient attendance is a reflection of the common conditions constituting the urological burden of a given population (1). The urological burden in turn has implications on access to care and treatment (2) since it will determine the skills needed, mode of treatment, amount of time and other resources required to meet these needs. There is, therefore, a need to have a local data base on the profile of our urological patients and their needs with regard to modes of treatment. This study strives to and meets this important objective. OBJECTIVE: To establish the epidemiology of outpatient urology patients and their service needs as seen in a tertiary centre in the Western region of Kenya. DESIGN: Hospital based observational, descriptive, prospective, cross sectional study. SETTING: The Urology Outpatient clinic of Moi Teaching and Referral Hospital (MTRH), a 750 bed tertiary centre in the Western region of Kenya catering for approximately half of the Kenyan population. SUBJECTS: Ninety-four first time attendees to the urology clinic seen in the year 2011. MAIN OUTCOME MEASURES: The primary outcome measures were the demographic data and diagnosis while the secondary outcome measure was the urological service needs of the patients in terms of treatment as to whether surgical or medical at presentation. RESULTS: Ninety-four patients attended the urology clinic for the first time in the year of study. The male to female ratio was 14.7: 1. Age ranged from one year to 97 years with a mean ± standard deviation of 48.0 ± 25.3 years. Half were below and half were above 50 years of age. Males had longer durations of symptoms compared to females but the difference was not statistically significant (p = 0.131). The top three urological problems were urethral strictures, prostate diseases and Urinary Tract Infections. There was an overall 70.2% need for surgical interventions with twenty-six point one percent of the prostate disorders being managed medically while all urethral strictures were planned for surgery. The odds ratio for surgery after one year compared to within first year of symptoms was two. CONCLUSION: The urological patients attending this tertiary outpatient clinic are predominantly males and are widely spread out in terms of age and diagnosis. The clinical burden of urethral strictures has overtaken that of prostate diseases in this tertiary centre.

Half of visible and half of recurrent visible hematuria cases have underlying pathology: prospective large cohort study with long-term followup.

PURPOSE: Visible hematuria has a cancer yield of up to 24.2%. A large proportion of cases will have no etiology. In this study we determined the incidence of pathology (benign and malignant) in patients with visible hematuria and those with persistent and recurrent visible hematuria, and evaluated the policy for investigations. MATERIALS AND METHODS: Data were prospectively collected for 1,804 patients with visible hematuria at a United Kingdom teaching hospital from January 1999 to September 2007. In October 2010 the comprehensive hospital electronic database was checked for every individual patient to ensure no urological pathology was missed. All patients underwent standard hematuria investigations, including renal tract ultrasound and excretory urography or contrast enhanced computer tomography urogram, flexible cystoscopy and urine cytology. RESULTS: The male-to-female ratio was 4.8:1. Median age ± SD was 67 ± 17.0 years (range 21 to 109). Median followup was 6.6 ± 2.5 years (range 1.5 to 11.6). No urological pathology was found in 965 (53.5%) patients. Malignant urological disease was found in 386 (21.4%) patients, of whom 329 had bladder tumors. There were 32 patients with persistent visible hematuria and no malignancy. Repeat investigation was performed in 69 patients reporting recurrence. Of these patients 35 received a significant urological diagnosis, including 12 (17.4%) urological malignancies, while 34 (49.3%) still had no diagnosis. Limitations include the possibility of missing pathology. CONCLUSIONS: Almost 50% of patients presenting with visible hematuria will have a diagnosis. Therefore, all cases of visible hematuria require full standard investigations. Patients with no diagnosis can be discharged from followup. Recurrent visible hematuria after full initial negative findings requires repeat full standard investigations because 11.6% will have malignant pathology.

Assessment of lower urinary tract symptoms in men by international prostate symptom score and core lower urinary tract symptom score.

UNLABELLED: Study Type - Therapy (symptom prevalence). Level of Evidence 2a. What's known on the subject? and What does the study add? The International Prostate Symptom Score (IPSS) has been most commonly used for the symptom assessment of men with lower urinary tract symptoms (LUTS). However, LUTS in men are so variable that they may not be fully captured by the IPSS questionnaire alone. This study has demonstrated that the Core Lower Urinary Tract Symptom Score (CLSS) questionnaire, which addresses 10 important symptoms, is an appropriate initial assessment tool for LUTS in men with various diseases/conditions. OBJECTIVE: International Prostate Symptom Score (IPSS) has been commonly used to assess lower urinary tract symptoms (LUTS). We have recently developed Core Lower Urinary Tract Symptom Score (CLSS). The aim of this study is to compare IPSS and CLSS for assessing LUTS in men. PATIENTS AND METHODS: Consecutive 515 men fulfilled IPSS and CLSS questionnaires. IPSS QOL Index was used as the QOL surrogate. The clinical diagnoses were BPH (n = 116), BPH with OAB wet (n =80), prostate cancer (n = 128), prostatitis (n = 68), underactive bladder (n = 8), others (n = 72), and controls (e.g., occult blood) (n = 42). Simple statistics and predictability of poor QOL (QOL Index 4 or greater) were examined. RESULTS: All symptom scores were significantly increased in symptomatic men compared with controls. Scores of corresponding symptoms of two questionnaires were significantly correlated (r = 0.58-0.85, all P < 0.0001). A multivariate regression model to predict poor QOL indicated nine symptoms (daytime frequency, nocturia, urgency, urgency incontinence, slow stream, straining, incomplete emptying, bladder pain and urethral pain) as independent factors. The hazard ratios for bladder pain (2.2) and urgency incontinence (2.0) were among the highest. All the nine symptoms are addressed in CLSS, while three symptoms (urgency incontinence, bladder, and urethral pain) are dismissed in IPSS. CONCLUSION: CLSS questionnaire is more comprehensive than IPSS questionnaire for symptom assessment of men with various diseases/conditions, although both questionnaires can capture LUTS with possible negative impact on QOL.

Multiple giant prostatic urethral stones with an ureteral stone in a young patient.

Giant prostatic urethral stones have been reported as a very rare entity, and the etiology of these stones is not clear. We report a case of a 40-year-old man with giant multiple prostatic urethral stones whereby the entire gland was replaced, and a big ureteral stone presented with voiding difficulty and recurrent urinary tract infections. In the literature, to our knowledge, this is the youngest case wherein giant prostatic urethral stones coexisted with a big ureteral stone. Many different-sized stones were observed endoscopically, some protruding into the urethra, and some filling different cavities on the prostate. Following cystoscopy, multiple giant prostatic stones weighing a total of 151 g were removed by the open retropubic route. We treated the big ureteral stone endoscopically.

Malakoplakia of prostate as a complication of transrectal needle biopsy.

We report a case of a 72-year-old male that underwent two sets of transrectal prostatic needle biopsy (TPNB) within 9 month period. Pathology showed unremarkable benign prostatic tissues in the first group of biopsies while extensive diffuse inflammation with the characteristic features of malakoplakia in the second set. Three cores in the repeat biopsy contained foci of prostatic adenocarcinoma as well. Occurrence of malakoplakia several months after TPNB in our case suggests that microorganisms may have been inoculated to the prostate during the biopsy procedure. We believe that malakoplakia must be added to the list of complications after TPNB.

[Comparison of self-estimation of disuric disorders gauged IPSS scale and qualities of lives QoL with self-estimation of sexual life gauged by IIEF-5 scale]. / Porównanie samooceny dolegliwosci dysurycznych mierzonych przy uzyciu skali IPSS i jakosci zycia QoL z samoocena zycia plciowego mierzonego skala IIEF-5.

Evaluation of men with a point scale is a simple method that can be used both in primary care and specialist in-patient treatment. Although its use is not widespread. International scoring system for evaluation of symptoms of the prostate is common in Poland (IPSS). Responses to the questionnaire are the basis of IPSS scale. Quality of life form (QoL) is in addition to the scale of IPSS. It defines subjective assessment of patient well-being in case of symptoms of lower urinary tract at the same level as at the time of the study. 5-point questionnaire IIEF-5 has been used in Poland since 1999 to assess men's sexual life. The aim of the study is to compare the assessment of disuric disorders measured using the International Prostate System Score (IPSS) and Quality of Life scale versus scale of men's sexual self-esteem IIEF-5 in men at the age of 50-70. The study included 1746 randomly selected residents of the district Cracow-Downtown, at the age of 50-70. Medical interview was carried out (including complaints of lower urinary tract symptoms (IPSS), quality of life (QoL) and sexual dysfunction (IIEF-5); physical examination with assessment of individual systems with particular emphasis on genitourinary system, physical examination of the prostate (DRE), PSA level in total and free fractions, a biopsy of the prostate under ultrasound control if necessary. For the analysis qualified 1746 men. The men were divided into groups called groups of disease: a suspicion of prostate cancer, can not rule out prostate cancer, prostate cancer confirmed, probable benign prostatic hyperplasia (BPH), no lesions. The largest was the group with probable benign prostatic hyperplasia 64.89% of the total respondents, followed by a group of men without lesions, 26.29%, a group of probable prostate cancer was 6.41% of the respondents, a group with whom you can not rule out prostate cancer was 1.89%, the smallest was the group with confirmed prostate cancer, 0.52% of all male respondents. The age groups were: 498 respondents aged 50-54 years and 391 aged 55-59, 397 aged 60-64 and 460 aged 65-70. Mean age was 59.24 years. Ppicked up data were processed and analized by STATA- 5,0. Differences between groups relative to answers for the questions of scales: IPSS, QoL and IIEEF5 questionnaire were analized by Mann-Whitney, Kruskal- Wallis, Scheffe's and chi2 tests. Homogeneity of the IPSS were analised by a Cronbach coefficient test. Accordance of each questions of the scale to whole scale were analised by correlation and line regression tests. Based on the analysis of the total scale score by IPSS and QoL scale and quality of life questionnaire IIEF-5 showed that in the process of aging in the population more frequently in older than in younger men, there are complaints from the urinary tract and deteriorating quality of life of self-esteem and quality of life of sexual self-esteem. After analyzing the result of scale: IPSS, QoL, and IIEF-5 in the disease groups, it was found that the total score of IPSS differentiates men in the group with probable benign prostatic hyperplasia, from a group of men without lesions and men with suspected prostate cancer. Statistically significant reduction in quality of life (QoL) in patients with confirmed prostate cancer and in the group with probable benign prostatic hyperplasia compared with men without lesions. The highest self-esteem sex life (IIEF-5) was found in men without lesions and the lowest in the group with known prostate cancer. The scale of quality of life (QoL) was significantly positively correlated with the results of IPSS scale, as well as with each of its questions. Deterioration in the quality of life occurred as a crescendo pain of lower respiratory tract. With the increase in the incidence and severity of each symptom on a scale IPSS worsening of self-esteem was examined using a scale IIEF-5. U of men with the deterioration of the quality of life measured by the scale of QoL, worsening their sexual self-esteem scale IIEF-5. In the process of aging are growing complaints from the lower urinary tract, self-esteem deteriorates the quality of life, including sexual life, which is especially marked in men with enlarged prostate. The scale of quality of life (QoL) is significantly positively correlated with the results of IPSS scale. With the increase in the incidence and severity of symptoms on a scale IPSS had decreased self-test using the IIEF-5 scale. The deterioration of quality of life measured with QoL was associated with decreased sexual self-esteem scale IIEF-5.

Blastomyces dermatitidis prostatic and testicular infection in eight dogs (1992-2005).

This was a retrospective case study of eight dogs diagnosed with prostatic or testicular B. dermatitidis infection. Signalment, clinical presentation, diagnostic procedures, and treatment options were evaluated. Review of medical records of dogs diagnosed with blastomycosis at the University of Illinois Veterinary Teaching Hospital from 1992 to 2005 yielded four dogs with prostatic blastomycosis (PB) and four dogs with testicular blastomycosis (TB). Three of the four dogs with PB and all four dogs with TB had evidence of urogenital disease. Three dogs with PB had an elevated body temperature and all had systemic disease. All dogs with TB had a normal body temperature, and three had systemic disease and one had clinical signs limited to testicular disease. Cytology or histopathology was used to diagnose PB or TB. Treatment included itraconazole or fluconazole with or without nonsteroidal anti-inflammatory drugs. PB and TB are infrequently recognized and may be under diagnosed due to failure to specifically evaluate these tissues. PB or TB should be considered in the evaluation and staging of male dogs with blastomycosis. Male dogs with urogenital signs should be evaluated via prostatic or testicular cytology or histopathology since proper identification and management of PB or TB may improve overall treatment success.

Prostate diseases in Lagos, Nigeria: a histologic study with tPSA correlation.

OBJECTIVE: To present a 10year retrospective histologic study of prostate diseases in Lagos, Nigeria. The aim is to document the prevalence, histologic pattern, age distribution and PSA values of prostatic diseases. MATERIALS AND METHODS: The materials consisted of slides, paraffin embedded tissue blocks, patients case files and histology request forms of all prostatic biopsies received at the Morbid Anatomy department of Lagos University Teaching Hospital Idi-Araba, Lagos from 1999 to 2008. Each sample represents a different patient. RESULTS: Prostatic biopsies comprised 3.6 % of all biopsies in LUTH. BPH was the commonest prostatic lesion and accounted for 70.9% of all cases. The age range was 40 to 94 years with a mean of 67 years and a peak age group at 60-69 years. Stromoglandular pattern was the most common histological type of BPH accounting for 72.2 %( 393) of the cases. Malignant tumours constituted 28.9% of all prostatic biopsies. Most (93.7%) of these malignancies were seen in trucut biopsies. Adenocarcinoma accounted for 99.1% of the total 222 malignant tumours. It showed an age range of 40 to 98 years, a mean age of 66 years and peak prevalence in the 60-69 year age group. Gleason score nine was the most frequent (16.8%) in occurrence. Most adenocarcinomas were poorly differentiated (40%). Incidental carcinoma was seen in 4.2% of prostatectomy samples. High grade PIN was seen in 19.1% of adenocarcinoma cases. The most common inflammatory lesion was chronic non-specific prostatitis accounting for 76.4% of all inflammatory lesions. Malignant and benign lesions were accountable for PSA levels of 1 to 49.9ng/ml while values of 50ng/ml and above were seen exclusively in malignant lesions. CONCLUSION: Prostatic lesions constitute a significant source of morbidity among adult males in Lagos. Adenocarcinoma is the commonest histologic subtype of prostatic cancer and most are of poorly differentiated variety. Elevated levels of tPSA in Nigerian males may be as a result prostate cancer, BPH or BPH with prostatitis. PSA should in our opinion be used as a component of a strategy integrating multiple diagnostic approaches for prostate cancer screening and not to be used alone in our environment.

Determinants of male reproductive health disorders: the Men in Australia Telephone Survey (MATeS).

BACKGROUND: The relationship between reproductive health disorders and lifestyle factors in middle-aged and older men is not clear. The aim of this study is to describe lifestyle and biomedical associations as possible causes of erectile dysfunction (ED), prostate disease (PD), lower urinary tract symptoms (LUTS) and perceived symptoms of androgen deficiency (pAD) in a representative population of middle-aged and older men, using the Men in Australia Telephone Survey (MATeS). METHODS: A representative sample (n = 5990) of men aged 40+ years, stratified by age and State, was contacted by random selection of households, with an individual response rate of 78%. All men participated in a 20-minute computer-assisted telephone interview exploring general and reproductive health. Associations between male reproductive health disorders and lifestyle and biomedical factors were analysed using multivariate logistic regression (odds ratio [95% confidence interval]). Variables studied included age, body mass index, waist circumference, smoking, alcohol consumption, physical activity, co-morbid disease and medication use for hypertension, high cholesterol and symptoms of depression. RESULTS: Controlling for age and a range of lifestyle and co-morbid exposures, sedentary lifestyle and being underweight was associated with an increased likelihood of ED (1.4 [1.1-1.8]; 2.9 [1.5-5.8], respectively) and pAD (1.3 [1.1-1.7]; 2.7 [1.4-5.0], respectively. Diabetes and cardiovascular disease were both associated with ED, with hypertension strongly associated with LUTS and pAD. Current smoking (inverse association) and depressive symptomatology were the only variables independently associated with PD. All reproductive disorders showed consistent associations with depression (measured either by depressive symptomatology or medication use) in both age-adjusted and multivariate analyses. CONCLUSION: A range of lifestyle factors, more often associated with chronic disease, were significantly associated with male reproductive health disorders. Education strategies directed to improving general health may also confer benefits to male reproductive health.

[Preoperative PSA levels and development of PSA after 180-W XPS greenlight laser treatment of the prostate: what is the reality in clinical routine practice?] / Präoperative PSA-Werte und PSA-Verlauf nach 180-Watt-XPS-Greenlight-Laserung der Prostata ­ wie ist die Realität im klinischen Alltag?

INTRODUCTION: The aim of this retrospective study was to evaluate preoperative levels of PSA (prostate-specific antigen) and the postoperative development after 180-W XPS™ greenlight laser treatment of the prostate under real-world conditions. METHOD: Preoperative PSA levels were evaluated in 749 patients undergoing a 180-W XPS greenlight laser procedure from 2012 to 2017 in Witten, Germany, in relation to age, volume of the prostate, urinary tract infection, Foley catheter and co-morbidities. The postoperative development of PSA was identified by retrieving PSA levels from general practitioners or urologists. RESULTS: The average age of the patients was 73.33 ±â€Š9.26 years. The prostate volume measured by rectal ultrasound was 42.42 ±â€Š18.33 ml. Median preoperative PSA was 2.59 ng/ml. In 268 patients (35.8 %), the PSA level was above 4 ng/ml. It was evaluated by prostate biopsy in 106 patients (39.6 %). 6 months after the surgical procedure (n = 86), PSA decreased to 1.25 ng/ml and increased slightly to 1.46 ng/ml after 12 months (n = 126). Logistic regression analysis demonstrated that a PSA level elevated to more than 4 ng/ml preoperatively is related to prostate volume (p = 0.001) the existence of a transurethral Foley catheter (p = 0.002), but not to age (p = 0.349), the existence of a suprapubic catheter (p = 0.207), an infection of the lower urinary tract (p = 0.966) and the number of co-morbidities mentioned in the discharge letter (p = 0.936). DISCUSSION: In line with expectations and clinical trials, there was a postoperative decrease of PSA by more than a half of the preoperative value. Significant factors related to preoperative elevation of the PSA level were prostate volume, a transurethral Foley catheter instead of the suprapubic type of catheter and a urinary infection. Although elevated PSA levels were seen in about one third of patients, evaluation by prostate biopsy was only performed in 39.6 % of these patients due to their performance status and other clinical issues.

Transrectal Ultrasound Guided Prostatic Biopsy and its Complications: A Descriptive Cross-sectional Study.

INTRODUCTION: Transrectal ultrasound of prostate provides better visual for biopsy. Transrectal ultrasound guided prostate biopsy is usually performed in men with an abnormal digital rectal examination, and elevated prostate specific antigen (>4ng/ml) or prostate specific antigen velocity (rate of prostate specific antigen change) i.e., >0.4-0.75ng/ml/year. The aim of the study is to find out the complications of transrectal ultrasound guided prostatic biopsies. METHODS: This descriptive cross-sectional study was done among 50 patients who transrectal ultrasound guided prostatic biopsies in a tertiary care hospital, from July 2017 to July 2019 after receiving ethical approval from the Institutional Review Committee of Kathmandu Medical College and teaching hospital. Convenient sampling was done. All patients were informed about the potential benefits and risks of the transrectal ultrasound guided prostate biopsy and patients signed an informed written consent form. Statistical analysis was done by using Statistical Package for Social Sciences version 16. RESULTS: Mean prostate specific antigen was 34.571 and mean weight of prostate was 44.6gm. Moderate to severe pain was experienced by 15 (30%), 2 (4%) had hematuria with fever accounting for 3 (6%) patients. All were managed conservatively with no mortality related to the procedure and complication. Three patients was positive for malignancy on re-biopsy. CONCLUSIONS: Transrectal ultrasound guided biopsy of prostate is a pioneer experience in Nepal. It has proved to be an useful tool of diagnosis of suspected carcinoma of Prostate. Use of neurovascular block may reduce the pain during the procedure.